Skin Firming Tips

Top products and procedures for a youthful complexion

Firm, supple, taut...there aren't many areas of the body for which those wouldn't be ideal descriptors. But unlike the bits that can be bound in Spanx or camo'd in clothing, the face reveals its resilience front and center. "Think about a piece of corduroy—that's what skin is like when you're young," L.A.-based dermatologist Jessica Wu, MD, says. "Once collagen production slows with age, skin becomes more like silk. It's thinner and wrinkles more easily." Luckily, these products and procedures will pick up the slack when skin starts to slump.

And when it comes to restoring youthfulness with injectables, Radiesse (calcium hydroxyapatite) volumizes sunken facial areas and fills in nasal labial folds, while Sculptra (poly-L-lactic acid) stimulates new collagen. "You can feel more elasticity in the skin after just one month," Waldorf says.

Micro Face-Lift
"ePrime will replace many existing skin-tightening technologies," predicts NYC-based derm Macrene Alexiades-Armenakas, MD, PhD, who has been involved with the treatment since its initial FDA trial in 2008. This one-time procedure, designed for the lower face and neck, uses 10 hair-thin needles to deliver short bursts of heat (149–162ºF is the ideal temperature range) to skin's deepest layer, stimulating both collagen and elastin production. In a comparative analysis among five leading dermatologists and plastic surgeons, ePrime's results were calculated at 37 percent of a face-lift. "You get one third of a face-lift's results but with only two to three days of downtime while swelling subsides," Alexiades says. ePrime has limited distribution, but with its recent FDA approval, it should be in more doctors' offices within the next year.

As collagen breaks down, peptides (small chains of amino acids) form, signaling the skin's collagen-creating fibroblasts to get to work. This process slows with age, but using a peptide-packed cream can trick the fibroblasts into amping up production.

But before new collagen can tighten skin, it must first fend off Pac-Man-like enzymes. "As we age, there is an increase in matrix metalloproteinases—enzymes in the skin that gobble up collagen and elastin," Wu says. Research published in the Journal of Investigative Dermatology found that topical vitamin A (in the form of retinol or retinoids, long used to increase cell turnover and reduce fine lines) reduces enzyme levels while simultaneously stimulating the fibroblasts. "The retinol molecule is small enough to reach the dermis, where collagen and elastin reside. Using vitamin A helps build new collagen and replace damaged tissue," Chapas says.